A Swedish alcohol ignition interlock programme for drink-drivers: effects on hospital care utilization and sick leave.

AIMS This project evaluates health outcomes following an alcohol ignition interlock programme (AIIP) by assessing hospital care utilization and sick-leave register data relative to controls with revoked licences, but with no comparable opportunity to participate in an AIIP. SETTING In Sweden, driving while impaired (DWI) offenders can now select voluntarily a 2-year AIIP in lieu of 12 months' licence revocation. The AIIP includes regular medical check-ups designed to alter alcohol use. DESIGN The study is a quasi-experimental intent-to-treat design; accordingly, the intervention group includes 48% of the participants who were dismissed from the AIIP before completion. FINDING The control group (865 individuals) showed increased hospital care and sick leave after licence revocation following the DWI. Among the 1266 people in the AIIP, however, significantly fewer needed hospital care relative to controls, and relative to their own care utilization before the DWI offence. This occurred whether care reflected all diagnosis or only alcohol-related diagnosis. Also, sick-leave data showed significantly fewer AIIP group individuals using sick leave relative to the control group, and relative to their own pre-treatment period. These significant health benefits disappear in the post-treatment period. However, among those who actually do complete the entire AIIP, sustained positive health effects are observed 3 and 4 years after the DWI offence. CONCLUSIONS Voluntary participation in an AIIP has favourable effects with less need for hospital care or sick leave. This is probably linked to reduced alcohol consumption during the programme and to the ability to continue driving.

[1]  A. Romelsjö,et al.  Drink driving and criminal behaviours as risk factors for receipt of disability pension and sick leave: a prospective study of young men. , 1999, Addiction.

[2]  S. Lapham,et al.  Accuracy of alcohol diagnosis among DWI offenders referred for screening. , 2004, Drug and alcohol dependence.

[3]  J. Brecht,et al.  Alcoholism. The cost of illness in the Federal Republic of Germany. , 1996, PharmacoEconomics.

[4]  K. Halmi,et al.  A placebo-controlled study of fluoxetine in continued treatment of bulimia nervosa after successful acute fluoxetine treatment. , 2002, The American journal of psychiatry.

[5]  Berk Kn,et al.  Repeated measures with zeros. , 2002 .

[6]  R B Voas,et al.  Deterring the drinking driver: the Stockton experience. , 1987, Accident; analysis and prevention.

[7]  P. Allebeck,et al.  Sick-leave in women with alcohol dependence or abuse: effects of additional psychiatric disorders , 1998, Social Psychiatry and Psychiatric Epidemiology.

[8]  H. Kristenson,et al.  Convictions for drunkenness or drunken driving, sick absenteeism, and morbidity in middle-aged males with different levels of serum gamma-glutamyltransferase. , 1982, Preventive medicine.

[9]  M. Marmot,et al.  Alcohol consumption and sickness absence: from the Whitehall II study. , 1993, Addiction.

[10]  Bo Bjerre.  Primary and secondary prevention of drink driving by the use of alcolock device and program: Swedish experiences. , 2005, Accident; analysis and prevention.

[11]  L H Moulton,et al.  A mixture model with detection limits for regression analyses of antibody response to vaccine. , 1995, Biometrics.

[12]  P. Deteix,et al.  Patients admitted to emergency services for drunkenness: moderate alcohol users or harmful drinkers? , 2001, The American journal of psychiatry.

[13]  T R Miller,et al.  How intoxicated are drivers in the United States? Estimating the extent, risks and costs per kilometer of driving by blood alcohol level. , 1999, Accident; analysis and prevention.

[14]  Robert B Voas,et al.  Vehicle action: effective policy for controlling drunk and other high-risk drivers? , 2002, Accident; analysis and prevention.

[15]  H L Ross,et al.  Effects of license revocation on drunk-driving offenders. , 1988, Accident; analysis and prevention.

[16]  Joseph L Schafer,et al.  A Two-Part Random-Effects Model for Semicontinuous Longitudinal Data , 2001 .

[17]  The Effect of Alcoholism Treatment on Medical Care Use , 2004, Medical care.

[18]  R. Room,et al.  Alcohol and public health , 2005, The Lancet.

[19]  Bo Bjerre,et al.  An Evaluation of the Swedish Ignition Interlock Program , 2003, Traffic injury prevention.